iodixanol: clinical use

Prescribing considerations

• Diagnostic use only; select the route and product according to the imaging procedure.
• Assess previous iodinated-contrast reactions, asthma, renal function, hydration, cardiovascular disease, neurological risk, thyroid disease and relevant medicines.
• Plan for immediate treatment of hypersensitivity and maintain suitable vascular access during intravascular procedures.
• Avoid unnecessary repeat exposure until renal function has returned to baseline.
• Hysterosalpingography is unsuitable during pregnancy or acute pelvic inflammatory disease.

Contraindications and cautions

• Hypersensitivity to iodixanol or an excipient
• Manifest thyrotoxicosis

Monitoring

• Observe after administration because most serious immediate reactions occur early, while delayed hypersensitivity remains possible.
• Assess renal function in at-risk patients and ensure clinically appropriate hydration.
• Monitor for extravasation and neurological symptoms suggestive of contrast encephalopathy.
• Evaluate thyroid function after exposure in children younger than three years; monitor newborns exposed in utero.

Clinical pharmacology

Iodixanol is a non-ionic, dimeric, hexaiodinated, water-soluble contrast medium. It distributes mainly in extracellular fluid, has minimal protein binding, is not detectably metabolised and is cleared predominantly unchanged by glomerular filtration.

Formulation and product differences

• The selected product is a clear, colourless to pale-yellow solution for injection in glass or polypropylene containers.
• It is made isotonic with body fluids by added electrolytes and contains sodium.
• Single-use containers should be inspected before use and unused portions discarded; larger pump containers require validated aseptic handling.
• Do not mix with other medicines; use a separate syringe.